4 research outputs found
The Efficiency of Glucocorticoid Therapy in Secondary-progressive Course of Multiple Sclerosis
We have investigated the efficacy of pulse-therapy with glucocorticoids (GC) at different time stages (in debuts, at the recurrent stage and at the stage of progression) of secondary progressive course (SPC) of multiple sclerosis (MS) in 70 patients (57 women and 13 men) at the ages from 28 to 67 years (mean age 45Β±2.5 years). The duration of the disease accounted for 7 up to 34 years (average duration was 19.8Β±2.3 years). We have conducted 438 courses of GC therapy: at the onsets β 11, at the recurrent stage (RS) β 178 and at the stage of secondary progression-249.The efficacy of hormonal therapy was assessed taking into account the following criteria: the dynamics of regression of neurological symptoms under the influence of the first course of GC therapy at the stage of onsets; a comparative evaluation of remission\u27s duration after admission and without taking GC at the onsets; duration of RS depending on the duration of remissions after the first course of GC therapy; a comparative evaluation of remissions\u27 duration after the 1st (at the stage of onset and/or on the RS), and the period of stabilization on the SPS before the last courses of GC; the variants of secondary progression under the influence of GC courses; scores according the EDSS disability scale after the 1st and before the last course of GC therapy; the rate of progression under the influence of the repeated courses of GC therapy.We have defined the three categories of efficacy at the repeated courses of pulse therapy with GC: the moderate efficacy, the low efficacy, the lack of efficacy. We have not observed the high efficacy in patients with SPC.The patients with MFR <1.0, among which the pulse therapy with GC promoted the prolongation of RS, relieved the severe (less often) and moderate (more often) relapses, the outcome of which was accompanied by a moderate and stable neurologic deficit, were subsumed under the subgroup with moderate efficacy (21 individuals). The most favorable progressive variant of progression prevailed in these patients after transformation of RS into SPS.The patients with different rate of MFR (9 β with MFR <1.0 and 12 β with MFR>1.0), with short (more often) and moderate (less often) RS, during which the accumulation of neurological deficit due to the frequent and heavy relapses had occurred, were subsumed under the subgroup with low efficiency (21 individuals). After transformation into SPS, the recurrent variant of progression prevailed in these patients.The patients who were characterized by short RS, by predominance of severe and prolonged relapses, the MFR value greater than 1.0, the steady accumulation of a pronounced and persistent neurologic deficit, a high rate of progression and high scores on the EDSS disability scale more than 6.5 points) were subsumed under the subgroup with the lack of efficacy (28 individuals). After transformation in the SPC, the most unfavorable variant of progression prevailed (21 patients); significantly less frequent were the recurrent (5 patients) and a combination of a steady and recurrent (2 patients) progression. The persistent lack of efficacy of the hormonal therapy in this subgroup of patients was most likely associated with the genetically determined low individual sensitivity to GC.Therefore, the results of our study showed that the efficacy of GC therapy in SPC of MS is determined by the complex interaction of clinical indicators having the prognostic value, as well as by the number of the genetic factors, which require their further observation
Matrix Metalloproteinase-9 and Inflammation in Different Types of Multiple Sclerosis
Different clinical courses of multiple sclerosis, heterogeneity of its clinical implications, different effect of immunomodulatory therapy for the same clinical forms implies various pathogenetic mechanisms of central nervous system damage at this disease. Applicability of immunological and biochemical markers for the estimation of immunocorrecting and anti-inflammatory therapy efficacy is important. This research aims at improvement of pathological process stages diagnostics at multiple sclerosis and further therapy optimization depending on the activity of the inflammatory process. In the article matrix metalloproteinase-9 rate was assessed in 135 patients with multiple sclerosis of different course types and at different activity stages of the pathological process. The highest matrix metalloproteinase-9 rates were in patients with relapsing-remitting type at the stage of exacerbation, with the lowest rate being in patients with primary-progressive multiple sclerosis. Determination of matrix metalloproteinase-9 rate allows to assess the degree of inflammatory process expression and to monitor the efficacy of multiple sclerosis treatment
Π‘ΠΎΠ΄ΠΡΠΆΠ°Π½ΠΈΠ ΡΠΡ-ΠΏΡΠΎΡΠ΅ΠΈΠ½Π Π ΠΏΠ»Π°Π·ΠΌΠ ΠΊΡΠΎΠ²Π ΠΏΡΠ ΠΏΡΠΎΠ³ΡΠ΅Π΄ΠΈΠ΅Π½ΡΠ½ΡΠ₯ ΡΠΈΠΏΠ°Π₯ ΡΠ΅ΡΠ΅Π½ΠΈΠ― ΡΠ°ΡΡΠ΅ΡΠ½Π½ΠΠ³Π ΡΠΊΠ»Π΅ΡΠΎΠ·Π
Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΡΡΠ²Π»Π΅Π½ΠΈΠ΅ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΠ°Ρ-ΠΏΡΠΎΡΠ΅ΠΈΠ½Π° Π΄Π»Ρ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΠΏΡΠΎΠ³ΡΠ΅Π΄ΠΈΠ΅Π½ΡΠ½ΡΡ
ΡΠΈΠΏΠΎΠ² ΡΠ΅ΡΠ΅Π½ΠΈΡ (ΠΠ’Π’) ΡΠ°ΡΡΠ΅ΡΠ½Π½ΠΎΠ³ΠΎ ΡΠΊΠ»Π΅ΡΠΎΠ·Π°.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. Π‘ΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ ΡΠ°Ρ-Π±Π΅Π»ΠΊΠ° Π² ΡΡΠ²ΠΎΡΠΎΡΠΊΠ΅ ΠΊΡΠΎΠ²ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΎΡΡ Π² ΡΡΠ΅Ρ
Π³ΡΡΠΏΠΏΠ°Ρ
Ρ 75 Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΡΠ°Π·Π½ΡΠΌΠΈ ΡΠΈΠΏΠ°ΠΌΠΈ ΡΠ΅ΡΠ΅Π½ΠΈΡ Π Π‘: 1-Ρ Π³ΡΡΠΏΠΏΠ° β 30 Π±ΠΎΠ»ΡΠ½ΡΡ
(20 ΠΆΠ΅Π½ΡΠΈΠ½ ΠΈ 10 ΠΌΡΠΆΡΠΈΠ½) Ρ Π²ΡΠΎΡΠΈΡΠ½ΠΎ-ΠΏΡΠΎΠ³ΡΠ΅Π΄ΠΈΠ΅Π½ΡΠ½ΡΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ; 2-Ρ Π³ΡΡΠΏΠΏΠ° β 15 Π±ΠΎΠ»ΡΠ½ΡΡ
(6 ΠΆΠ΅Π½ΡΠΈΠ½ ΠΈ 9 ΠΌΡΠΆΡΠΈΠ½) Ρ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎ-ΠΏΡΠΎΠ³ΡΠ΅Π΄ΠΈΠ΅Π½ΡΠ½ΡΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ; 3-Ρ Π³ΡΡΠΏΠΏΠ° (ΠΊΠΎΠ½ΡΡΠΎΠ»ΡΠ½Π°Ρ) β 30 Π±ΠΎΠ»ΡΠ½ΡΡ
(24 ΠΆΠ΅Π½ΡΠΈΠ½Ρ ΠΈ 6 ΠΌΡΠΆΡΠΈΠ½) Ρ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²ΠΈΡΡΡΡΠΈΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ.ΠΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ ΡΠ°Ρ-ΠΏΡΠΎΡΠ΅ΠΈΠ½Π° ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΡΡ Π² Π»Π°Π±ΠΎΡΠ°ΡΠΎΡΠΈΠΈ Π½Π΅ΠΉΡΠΎΡΠΈΠ·ΠΈΠΎΠ»ΠΎΠ³ΠΈΠΈ, ΠΈΠΌΠΌΡΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΈ Π±ΠΈΠΎΡ
ΠΈΠΌΠΈΠΈ ΠΠ£ ΠΠ½ΡΡΠΈΡΡΡ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΡΠΈΡ
ΠΈΠ°ΡΡΠΈΠΈ ΠΈ Π½Π°ΡΠΊΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΠ°ΡΠΈΠΎΠ½Π°Π»ΡΠ½ΠΎΠΉ Π°ΠΊΠ°Π΄Π΅ΠΌΠΈΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΡ
Π½Π°ΡΠΊ Π£ΠΊΡΠ°ΠΈΠ½Ρ ΠΈΠΌΠΌΡΠ½ΠΎΡΠ»ΡΠΎΡΠ΅ΡΡΠ΅Π½ΡΠ½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ. ΠΡΠΎΡ ΠΌΠ΅ΡΠΎΠ΄ Π΄Π°Π΅Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΡΡΠ±ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½ΡΠ° Ρ ΠΏΠΎΠΌΠΎΡΡΡ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈΠΌΠΌΡΠ½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅Π°ΠΊΡΠΈΠΈ. ΠΠ½ ΠΎΠ±Π»Π°Π΄Π°Π΅Ρ Π²ΡΡΠΎΠΊΠΎΠΉ ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡΡ ΠΈ ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡΡ. ΠΡΠ»ΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½Ρ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠ΅ Π½Π°Π±ΠΎΡΡ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π° ΡΠΈΡΠΌΡ Β«SigmaΒ» (Π‘Π¨Π). ΠΠ°Π½Π½ΡΠΉ ΠΌΠ΅ΡΠΎΠ΄ Π΄Π°Π΅Ρ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΊΠ°ΠΊ ΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ Π²ΠΈΠ·ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΎΠΏΠΈΡΠ°ΒΠ½ΠΈΡ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠ΅ΠΉ ΡΠ°ΡΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΠΎΠΏΡΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΠ»ΠΎΡΠ½ΠΎΡΡΠΈ ΡΠ°Ρ-Π±Π΅Π»ΠΊΠ° Ρ ΠΊΠ°ΠΆΠ΄ΠΎΠ³ΠΎ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°, ΡΠ°ΠΊ ΠΈ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΡΡΠΎΠ²Π½Ρ ΡΠ°Ρ-Π±Π΅Π»ΠΊΠ° Π² ΡΡΠ²ΠΎΡΠΎΡΠΊΠ΅ ΠΊΡΠΎΠ²ΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΡΡΠ°Π²Π½ΠΈΡΠ΅Π»ΡΠ½Π°Ρ ΠΎΡΠ΅Π½ΠΊΠ° ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΡ ΡΠ°Ρ-ΠΏΡΠΎΡΠ΅ΠΈΠ½Π° Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ ΡΠΈΠΏΠ° ΡΠ΅ΡΠ΅Π½ΠΈΡ, Π³Π΅Π½Π΄Π΅ΡΠ½ΡΡ
ΡΠ°Π·Π»ΠΈΡΠΈΠΉ, Π²ΠΎΠ·ΡΠ°ΡΡΠ° Π±ΠΎΠ»ΡΠ½ΡΡ
Π² ΠΌΠΎΠΌΠ΅Π½Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ, Π²ΠΎΠ·ΡΠ°ΡΡΠ° Π½Π°ΡΠ°Π»Π° Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ (ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π΄Π΅Π±ΡΡΠ°), Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, ΡΡΠΎΠ²Π½Ρ Π½Π΅Π²ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π΄Π΅ΡΠΈΡΠΈΡΠ° ΠΏΠΎ ΡΠΊΠ°Π»Π΅ ΠΈΠ½Π²Π°Π»ΠΈΠ΄ΠΈΠ·Π°ΡΠΈΠΈ EDSS ΠΈ ΠΏΠΎΠΈΡΠΊ ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΡΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΈ, ΡΡΠΎ ΡΡΠΎΠ²Π΅Π½Ρ ΡΠ°Ρ-ΠΏΡΠΎΡΠ΅ΠΈΠ½Π° Π² ΡΡΠ²ΠΎΡΠΎΡΠΊΠ΅ ΠΊΡΠΎΠ²ΠΈ Π·Π°Π²ΠΈΡΠΈΡ ΠΎΡ ΡΠΈΠΏΠ° ΡΠ΅ΡΠ΅Π½ΠΈΡ ΡΠ°ΡΡΠ΅ΡΠ½Π½ΠΎΠ³ΠΎ ΡΠΊΠ»Π΅ΡΠΎΠ·Π° ΠΈ ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°Π΅Ρ ΠΏΡΠΈ ΠΏΡΠΎΠ³ΡΠ΅Π΄ΠΈΠ΅Π½ΡΠ½ΡΡ
ΡΠΈΠΏΠ°Ρ
ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΏΠΎ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Ρ Π³ΡΡΠΏΠΏΠΎΠΉ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΡΠ΅ΠΌΠΈΡΠΈΡΡΡΡΠΈΠΌ ΡΠΈΠΏΠΎΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΡ. ΠΠ»ΠΈΡΠ½ΠΈΠ΅ Π³Π΅Π½Π΄Π΅ΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΡΠΎΡΠ° Π½Π° ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ ΡΠ°Ρ-ΠΏΡΠΎΡΠ΅ΠΈΠ½Π° ΠΏΡΠΈ ΡΠ°Π·Π½ΡΡ
ΡΠΈΠΏΠ°Ρ
ΡΠ΅ΡΠ΅Π½ΠΈΡ ΡΠ°ΡΡΠ΅ΡΠ½Π½ΠΎΠ³ΠΎ ΡΠΊΠ»Π΅ΡΠΎΠ·Π° Π½ΠΎΡΠΈΠ»ΠΎ ΠΈΠ·Π±ΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΡΠΉ Ρ
Π°ΡΠ°ΠΊΡΠ΅Ρ ΠΈ ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°Π»ΠΎ ΡΠΎΠ»ΡΠΊΠΎ Ρ ΠΆΠ΅Π½ΡΠΈΠ½ ΠΏΡΠΈ ΠΏΠ΅ΡΠ²ΠΈΡΠ½ΠΎ-ΠΏΡΠΎΠ³ΡΠ΅Π΄ΠΈΠ΅Π½ΡΠ½ΠΎΠΌ ΡΠΈΠΏΠ΅ ΡΠ΅ΡΠ΅Π½ΠΈΡ. ΠΠ±Π½Π°ΡΡΠΆΠ΅Π½Ρ ΡΠ»ΠΎΠΆΠ½ΡΠ΅ Π²Π·Π°ΠΈΠΌΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΡ ΠΌΠ΅ΠΆΠ΄Ρ ΡΡΠΎΠ²Π½Π΅ΠΌ ΡΠ°Ρ-ΠΏΡΠΎΡΠ΅ΠΈΠ½Π°, Π²ΠΎΠ·ΡΠ°ΡΡΠΎΠΌ Π΄Π΅Π±ΡΡΠ°, Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ ΡΠΈΠΏΠΎΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΡ ΡΠ°ΡΡΠ΅ΡΠ½Π½ΠΎΠ³ΠΎ ΡΠΊΠ»Π΅ΡΠΎΠ·Π°.ΠΡΠ²ΠΎΠ΄Ρ. 1. ΠΡΠΎΠ²Π΅Π΄Π΅Π½Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΡΠ²ΠΈΠ΄Π΅ΡΠ΅Π»ΡΡΡΠ²ΡΠ΅Ρ ΠΎ ΡΠΎΠΌ, ΡΡΠΎ ΡΠ°Ρ-ΠΏΡΠΎΡΠ΅ΠΈΠ½ ΡΡΠ°ΡΡΠ²ΡΠ΅Ρ Π² ΠΌΠ΅Ρ
Π°Π½ΠΈΠ·ΠΌΠ°Ρ
ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π΄Π΅Π³Π΅Π½Π΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ° ΠΏΡΠΈ ΠΏΡΠΎΠ³ΡΠ΅Π΄ΠΈΠ΅Π½ΡΠ½ΡΡ
ΡΠΈΠΏΠ°Ρ
ΡΠ΅ΡΠ΅Π½ΠΈΡ Π Π‘.2. ΠΠΎΠ»ΡΡΠ΅Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΎ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΠΌ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠΈ ΡΡΠΎΠ³ΠΎ ΠΊΡΠΈΡΠ΅ΡΠΈΡ Π² ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ΅ ΠΏΡΠΎΠ³Π½ΠΎΠ·Π° ΠΏΡΠΎΠ³ΡΠ΅Π΄ΠΈΠ΅Π½ΡΠ½ΡΡ
ΡΠΈΠΏΠΎΠ² ΡΠ΅ΡΠ΅Π½ΠΈΡ ΡΠ°ΡΡΠ΅ΡΠ½Π½ΠΎΠ³ΠΎ ΡΠΊΠ»Π΅ΡΠΎΠ·
MATRIX METALLOPROTEINASE-9 AND INFLAMMATION IN DIFFERENT TYPES OF MULTIPLE SCLEROSIS
Different clinical courses of multiple sclerosis, heterogeneity of its clinical implications, different effect of immunomodulatory therapy for the same clinical forms implies various pathogenetic mechanisms of central nervous system damage at this disease. Applicability of immunological and biochemical markers for the estimation of immunocorrecting and anti-inflammatory therapy efficacy is important. This research aims at improvement of pathological process stages diagnostics at multiple sclerosis and further therapy optimization depending on the activity of the inflammatory process. In the article matrix metalloproteinase-9 rate was assessed in 135 patients with multiple sclerosis of different course types and at different activity stages of the pathological process. The highest matrix metalloproteinase-9 rates were in patients with relapsing-remitting type at the stage of exacerbation, with the lowest rate being in patients with primary-progressive multiple sclerosis. Determination of matrix metalloproteinase-9 rate allows to assess the degree of inflammatory process expression and to monitor the efficacy of multiple sclerosis treatment